Provider Demographics
NPI:1538348552
Name:KORASKA, TUULA H (LCSW)
Entity type:Individual
Prefix:
First Name:TUULA
Middle Name:H
Last Name:KORASKA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6147 DUNCAN RD
Mailing Address - Street 2:# E
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-7498
Mailing Address - Country:US
Mailing Address - Phone:804-306-7136
Mailing Address - Fax:
Practice Address - Street 1:6147 DUNCAN RD
Practice Address - Street 2:# E
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-7498
Practice Address - Country:US
Practice Address - Phone:804-306-7136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040064211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical